AIMS: To evaluate current research on the health, safety and health promotion needs of older workers by identifying age-related change, whether older workers need support and evidence of successful intervention in the workplace.METHODS: Using a systematic review methodology, databases were searched identifying 180 publications. Each publication was reviewed and data were extracted. Evidence was assessed for quality using the three-star system.RESULTS: The review identified that there are a number of age-related physical and psychological changes. However, these changes can be moderated by increased physical activity, intellectual activity and other lifestyle factors. Sensory abilities are also subject to change but some of these can be accommodated via equipment or workplace adjustments. In reviewing accident data, although older workers are at a reduced risk of accidents, they are more at risk of fatal accidents. Ill-health data identify that many chronic diseases can be controlled and adjustments put in place in the work environment. A number of intervention studies were identified but few were of high quality. The research suggests that occupational health intervention can reduce the risk of early retirement from the workplace; health promotion interventions are seen as positive by older workers but it is important to ensure equal access to all workers in such promotions.CONCLUSIONS: The review identified that there are still a large number of research gaps including the lack of longitudinal research; no further analysis on fatal accidents or understanding of the high prevalence of musculoskeletal disorders and stress and anxiety in older workers.